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The impact of age and gender on adherence to antidepressants: a 4-year population-based cohort study

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Abstract

Introduction

Impaired adherence is common among patients using antidepressant drugs (ADs). However, few studies investigated the role of age and gender in adherence to AD and finding conflict.

Objective

This study aimed to determine how gender and age impact adherence to AD in a large-scale cohort.

Methods

We conducted a historical cohort study (N = 310,994 individuals) that claimed AD prescriptions during a 4-year period. Adherence was defined as the ratio between the duration of claimed AD prescriptions and the duration of continuously prescribed AD.

Results

Substantial differences in the mean adherence to AD were noted throughout the lifespan, ranging from 0.38 (first decade) to 0.63 (tenth decade). Average adherence was significantly higher for males aged 20–40 years than for females of that age, but this relationship reversed later in life (50–70 years). A regression analysis model of adherence as the dependent variable showed a significant interaction between age and gender variables (beta = 0.001, p < 0.0001).

Conclusions

This study demonstrates the effect of age and gender, and their interaction, on adherence to AD across the entire life span. The marked age- and modest, yet significant, gender-related effects should be taken into consideration when targeting impaired adherence to these commonly prescribed medications.

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References

  • Bambauer KZ, Adams AS, Zhang F, Minkoff N, Grande A, Weisblatt R, Soumerai SB, Ross-Degnan D (2006) Physician alerts to increase antidepressant adherence: fax or fiction? Arch Intern Med 166:498–504

    Article  CAS  PubMed  Google Scholar 

  • Beck CA, Patten SB, Williams JV, Wang JL, Currie SR, Maxwell CJ, El-Guebaly N (2005) Antidepressant utilization in Canada. Soc Psychiatr Psychiatr Epidemiol 40:799–807

    Article  Google Scholar 

  • Bulloch AG, Patten SB (2010) Non-adherence with psychotropic medications in the general population. Soc Psychiatr Psychiatr Epidemiol 45:47–56

    Article  Google Scholar 

  • Burra TA, Chen E, McIntyre RS, Grace SL, Blackmore ER, Stewart DE (2007) Predictors of self-reported antidepressant adherence. Behav Med 32:127–134

    Article  PubMed  Google Scholar 

  • Charlson ME, Pompei P, Ales KL, MacKenzie CR (1987) A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis 40:373–383

    Article  CAS  PubMed  Google Scholar 

  • Compton MT, Rudisch BE, Weiss PS, West JC, Kaslow NJ (2005) Predictors of psychiatrist-reported treatment-compliance problems among patients in routine U.S. psychiatric care. Psychiatr Res 137:29–36

    Article  Google Scholar 

  • Davis DP, Jandrisevits MD, Iles S, Weber TR, Gallo LC (2012) Demographic, socioeconomic, and psychological factors related to medication non-adherence among emergency department patients. J Emerg Med 43:773–785

    Article  PubMed  Google Scholar 

  • Geddes JR, Carney SM, Davies C, Furukawa TA, Kupfer DJ, Frank E, Goodwin GM (2003) Relapse prevention with antidepressant drug treatment in depressive disorders: a systematic review. Lancet 361:653–661

    Article  CAS  PubMed  Google Scholar 

  • Goethe JW, Woolley SB, Cardoni AA, Woznicki BA, Piez DA (2007) Selective serotonin reuptake inhibitor discontinuation: side effects and other factors that influence medication adherence. J Clin Psychopharmacol 27:451–458

    Article  PubMed  Google Scholar 

  • Hansen DG, Vach W, Rosholm JU, Sondergaard J, Gram LF, Kragstrup J (2004) Early discontinuation of antidepressants in general practice: association with patient and prescriber characteristics. Fam Pract 21:623–629

    Article  PubMed  Google Scholar 

  • Hetrick S, Merry S, McKenzie J, Sindahl P, Proctor M (2007) Selective serotonin reuptake inhibitors (SSRIs) for depressive disorders in children and adolescents. Cochrane Database Syst Rev CD004851

  • Hunot VM, Horne R, Leese MN, Churchill RC (2007) A cohort study of adherence to antidepressants in primary care: the influence of antidepressant concerns and treatment preferences. Prim Care Companion J Clin Psychiatr 9:91–99

    Article  Google Scholar 

  • Isacsson G, Boethius G, Henriksson S, Jones JK, Bergman U (1999) Selective serotonin reuptake inhibitors have broadened the utilisation of antidepressant treatment in accordance with recommendations. Findings from a Swedish prescription database. J Affect Disord 53:15–22

    Article  CAS  PubMed  Google Scholar 

  • Kivimaki M, Gunnell D, Lawlor DA, Davey SG, Pentti J, Virtanen M, Elovainio M, Klaukka T, Vahtera J (2007) Social inequalities in antidepressant treatment and mortality: a longitudinal register study. Psychol Med 37:373–382

    Article  PubMed  Google Scholar 

  • Krivoy A, Balicer RD, Feldman B, Hoshen M, Zalsman G, Weizman A, Shoval G (2015) Adherence to antidepressant therapy and mortality rates in ischaemic heart disease: cohort study. Br J Psychiatr 206:297–301

    Article  Google Scholar 

  • Lingam R, Scott J (2002) Treatment non-adherence in affective disorders. Acta Psychiatr Scand 105:164–172

    Article  PubMed  Google Scholar 

  • Mavandadi S, Klaus JR, Oslin DW (2012) Age group differences among veterans enrolled in a clinical service for behavioral health issues in primary care. Am J Geriatr Psychiatr 20:205–214

    Article  Google Scholar 

  • Olfson M, Marcus SC, Tedeschi M, Wan GJ (2006) Continuity of antidepressant treatment for adults with depression in the United States. Am J Psychiatr 163:101–108

    Article  PubMed  Google Scholar 

  • Pai AL, McGrady M (2014) Systematic review and meta-analysis of psychological interventions to promote treatment adherence in children, adolescents, and young adults with chronic illness. J Pediatr Psychol

  • Percudani M, Barbui C, Fortino I, Petrovich L (2004) Antidepressant drug use in Lombardy, Italy: a population-based study. J Affect Disord 83:169–175

    Article  PubMed  Google Scholar 

  • Sawada N, Uchida H, Suzuki T, Watanabe K, Kikuchi T, Handa T, Kashima H (2009) Persistence and compliance to antidepressant treatment in patients with depression: a chart review. BMC Psychiatr 9:38

    Article  Google Scholar 

  • Sewitch MJ, Cole M, McCusker J, Ciampi A, Dyachenko A (2008) Medication use and nonadherence to psychoactive medication for mental health problems by community-living Canadian seniors with depression. Can J Psychiatr 53:609–620

    Google Scholar 

  • Singer SR, Hoshen M, Shadmi E, Leibowitz M, Flaks-Manov N, Bitterman H, Balicer RD (2012) EMR-based medication adherence metric markedly enhances identification of nonadherent patients. Am J Manag Care 18:e372–e377

    PubMed  Google Scholar 

  • Sirey JA, Greenfield A, Weinberger MI, Bruce ML (2013) Medication beliefs and self-reported adherence among community-dwelling older adults. Clin Ther 35:153–160

    Article  PubMed Central  PubMed  Google Scholar 

  • Stein MB, Cantrell CR, Sokol MC, Eaddy MT, Shah MB (2006) Antidepressant adherence and medical resource use among managed care patients with anxiety disorders. Psychiatr Serv 57:673–680

    Article  PubMed  Google Scholar 

  • van Dijk L, Heerdink ER, Somai D, van Dulmen S, Sluijs EM, de Ridder DT, Griens AM, Bensing JM (2007) Patient risk profiles and practice variation in nonadherence to antidepressants, antihypertensives and oral hypoglycemics. BMC Health Serv Res 7:51

    Article  PubMed Central  PubMed  Google Scholar 

  • Vos T, Haby MM, Barendregt JJ, Kruijshaar M, Corry J, Andrews G (2004) The burden of major depression avoidable by longer-term treatment strategies. Arch Gen Psychiatr 61:1097–1103

    Article  PubMed  Google Scholar 

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Conflict of interest

None of the authors reports any conflict of interest with regard to this study. This study was not supported by any grants or other funding.

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Correspondence to Gal Shoval.

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Krivoy, A., Balicer, R.D., Feldman, B. et al. The impact of age and gender on adherence to antidepressants: a 4-year population-based cohort study. Psychopharmacology 232, 3385–3390 (2015). https://doi.org/10.1007/s00213-015-3988-9

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  • DOI: https://doi.org/10.1007/s00213-015-3988-9

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